(005) The Forgotten Region of the Vestibule: The 12:00 Location

Abstract Introduction The vestibule, consisting of the urethral meatus and minor major vestibular glands, is a unique surface endodermal tissue between Hart’s line, at inner aspect labia minora, hymen, just vaginal opening. vestibule releases mucinous lubrication during sexual arousal, achieved, in part, by robust innervation. Although not well studied, this likely consists both somatic (perineal nerve), autonomic (pelvic hypogastric) nerves. commonly involved entrance dyspareunia pathology related to infectious, dermatologic, hormonal, neurologic, pelvic floor, neuro-proliferative other factors. Examination symptomatic patients best performed vulvoscopy, usually involves cotton swab testing 1:00, 3:00, 5:00, 6:00, 7:00, 9:00, 11:00 locations, assessing for intensity pain degree erythema. However, examination does assess entire vestibule. actually extends superiorly from above below clitoris/right left frenulum laterally line. This may be considered as “12:00” region vestibule; few providers examine there, surgeons excise 12:00 vestibulectomy. Objectives primary goal was relationship usual locations. A secondary presence ostia glands Methods Women presenting our clinic dysfunction were consented underwent vulvoscopy with photography using vulvoscope (Wallach Zoomscope) attached camera (Cannon). Figure 1 shows erythema 12:00. Pain rated 0 – 10, >3/10 clinically significant. Erythema absent, mild, moderate or severe any Results Of 88 (mean age 42 +/− 19, range 13-83 years) various dysfunctions who testing, 19 (22%) had absent throughout locations location. 54 (61%) positive findings significant least 4 38 (70%) also 26% photographs examined revealed obvious single multiple 2 Conclusions While line hymen including it includes There are that can contain pathology. Providers encouraged consider diagnosis treatment women dysfunction. Disclosure No.